Provider Demographics
NPI:1518283258
Name:NASSIF, CARRIE LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LEE
Last Name:NASSIF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:NASSIF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:205 E 7TH ST
Mailing Address - Street 2:STE 215
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4161
Mailing Address - Country:US
Mailing Address - Phone:785-623-4447
Mailing Address - Fax:
Practice Address - Street 1:205 E 7TH ST
Practice Address - Street 2:STE 215
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4161
Practice Address - Country:US
Practice Address - Phone:785-623-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical